Code: Q4125

Description:
Description: Arthroflex, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
ARTHROFLEX 28 SQ CM 1THK
ARTHROFLEX 28 SQ CM 2THK
ARTHROFLEX 45 SQ CM
ARTHROFLEX 40X70MM 3THK
ARTHROFLEX 1 SQ CM
GRAFT ARTHROFLEX FLEXIGRAFT DERMIS 35X35X1.26-1.75MM SOFT TISSUE PATCH
GRAFT ARTHROFLEX FLEXIGRAFT DERMIS 40X70X1.26-1.75MM SOFT TISSUE PATCH
GRAFT DERMIS 70X40X2MM SOFT TISSUE DECELLULARIZED LATEX FREE
GRAFT ARTHROFLEX THK.76-1.25MM DECELLULARIZED DERMIS 70X40MM SOFT TISSUE
Related codes:
Code: Q4120
Code: Q4121
THERASKIN 6SQCM
Code: Q4122
DERMACELLAWMPORO 1SQCM
Code: Q4123
ALLOSKIN RT 1SQCM
Code: Q4124
OASIS TRI MATRIX 35SQCM
Code: Q4126
DERMASPAN 25 SQ CM
Code: Q4127
Description: Talymed, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q4128
FLEXALLOPMATR HD 1SQCM
Wisconsin
Hospital Address Code Price Last Updated
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, Q4125 $4,896 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau Q4125 $4,896 [source] 4 years ago
Aspirus Riverview Hospital 410 Dewey St, Wisconsin Rapids Q4125 $5,881 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q4125 $6,574 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q4125 $7,078 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington Q4125 $7,078 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q4125 $7,655 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford Q4125 $7,670 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers Q4125 $7,871 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette Q4125 $9,449 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay Q4125 $9,449 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee Q4125 $11,176 [source] 4 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown Q4125 $11,403 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q4125 $13,572 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton Q4125 $15,487 [source] 4 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.